Whenever we fall ill, there are many different factors that cometogether to influence the course of our illness. Additional medicalconditions, stress levels, and social support all have an impact on ourhealth and well-being, especially when we are ill. But a new reportsuggests that what you think about your illness matters just as much, ifnot more, in determining your health outcomes. In the February issue ofCurrent Directions in Psychological Science, a journal of theAssociation for Psychological Science, Keith Petrie, of the Universityof Auckland, and John Weinman, of the Institute of Psychiatry at King'sCollege, review the existing literature on patients' perceptions ofillness. The authors find that people's illness perceptions bear adirect relationship to several important health outcomes, includingtheir level of functioning and ability, utilization of health care,adherence to treatment plans laid out by health care professionals, andeven overall mortality.

In fact, some research suggests that how a person views his illness mayplay a bigger role in determining his health outcomes than the actualseverity of his disease.

In general, our illness perceptions emerge out of our beliefs aboutillness and what illness means in the context of our lives. So, we mighthave beliefs about how an illness is caused, how long it will last, howit will impact us or our family members, and how we can control or cureit. The bottom line, says Petrie, is that "patients' perceptions oftheir illness guide their decisions about health." If, for example, wefeel like a prescribed treatment isn't making us feel better we mightstop that treatment.

Research on illness perceptions suggest that effective health caretreatment plans are about much more than having a competent physician.According to Petrie, "a doctor can make accurate diagnoses and haveexcellent treatments but if the therapy doesn't fit with the patient'sview of their illness, they are unlikely to keep taking it." A treatmentthat does not consider the patient's view is likely to fail, he argues.

The authors conclude that understanding illness perceptions andincorporating them into health care is critical to effective treatment.Asking patients about how they view their illness gives physicians theopportunity to identify and correct any inaccurate beliefs patients mayhave. Once a patient's illness perceptions are clearly laid out, aphysician can try to nudge those beliefs in a direction that is morecompatible with treatment or better health outcomes. Such conversationscan help practitioners identify patients that are at particular risk ofcoping poorly with the demands of their illness.

Research confirms that brief, straightforward psychoeducationalinterventions can modify negative illness beliefs and lead toimprovements over a range of different health outcomes. But thisresearch is still new and scientists don't know much about how ourillness perceptions develop in the first place. With mounting pressureto lower the costs of healthcare, continued research on illnessperceptions will help practitioners design effective interventions thatare able to reach a large number of patients.